Onychomycosis is a superficial fungal infection and one of the most common diseases in dermatology. Approximately 10% of the population of Japan is estimated to be affected with onychomycosis.　The prevalence of patients with onychomycosis is thought to be increasing in the aging society of Japan. The QOL of patients with onychomycosis is impaired by the deformities in their nails. Several topical and systemic antifungals are available in Japan, and Japanese guidelines for dermatomycosis have been published. Treatment for onychomycosis is therefore accessible to the public. However, the cure rate for onychomycosis is low because of misdiagnosis, insufficient therapy, and discontinuation of treatment.
　Dermatologists should be proficient in carrying out direct microscopic examination of fungi because this skill remains the gold standard for the diagnosis of onychomycosis. Topical antifungal therapy for onychomycosis is safe and applicable to elderly patients, but a large number of onychomycosis patients cannot be cured by this method. Severe cases should be treated by oral antifungals.

　Proper explanation of the duration and necessity of onychomycosis treatment at the first medical examination and follow-up of the patient with nail care can help in ensuring continued treatment of onychomycosis. Dermatologists should be fully aware that onychomycosis is a fungal infection that is curable by proactive antifungal therapy.

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